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成人型呼吸窘迫综合征(ARDS)发现于1967年,是临床各科多种原发疾病如休克、创伤、烧伤,体外循环后和严重感染等抢救或医治过程中发生的急性进行性缺氧性呼吸衰竭。肺脏的病理和病理生理主要改变为微血管壁通透性增加和肺泡群萎陷,导致通气和血流比率失调,肺内血液分流增多。在临床上表现为严重的不易缓解的低氧血症和呼吸频数、困难。ARDS也可见于儿童,它不同于先天性肺表面活性物质缺陷所致的婴儿型呼吸窘迫综合征。据国内外文献介绍,ARDS的原发病中还包括多种传染病,所以重视传染病与ARDS的密切关系颇为必要。一、传染病时ARDS的发病机制在严重传染病的情况下,由于病原微生物及其毒素、感染性休克、局部缺血、组织损伤和酸中毒等有害影响,引起肺部一系列病理变化:(1)由于肺循环出现大量炎性介质,例如组织胺、5-羟色胺、
The adult respiratory distress syndrome (ARDS), found in 1967, is an acute progressive hypoxia that occurs during the rescue or treatment of a variety of primary diseases in the clinical setting such as shock, trauma, burn, cardiopulmonary bypass and severe infections Respiratory failure. Pulmonary pathology and pathophysiology of the main changes in microvascular wall permeability and alveolar collapse, resulting in imbalance of ventilation and blood flow, pulmonary blood shunt increased. In clinical manifestations of severe and difficult to alleviate hypoxemia and respiratory rate, difficulty. ARDS is also seen in children, which is different from infantile respiratory distress syndrome due to congenital defects of pulmonary surfactant. According to the literature at home and abroad, the primary disease of ARDS also includes a variety of infectious diseases, it is quite necessary to attach importance to the close relationship between infectious diseases and ARDS. First, the pathogenesis of ARDS in infectious diseases Severe infectious diseases, the pathogenic microorganisms and their toxins, septic shock, ischemia, tissue damage and acidosis and other harmful effects, causing a series of pathological changes in the lungs :( 1) due to the pulmonary circulation appear a large number of inflammatory mediators, such as histamine, serotonin,